Integrity and Leadership
Integrity is the adherence to interrelated values, principles, and standards which are derived from three domains that are known to affect our decisions. These domains are professional, personal, and organizational since this proves to be our day to day programs. Integrity is a requirement for leadership in general and in healthcare and nursing in particular. The agility to which a leader follows and respects the codes or rather standards that govern each of the above domains defines his integrity. By itself, integrity cannot be considered a value.
The relationship between the decisions and behaviors of an individual, together with his attachment to the values of the community within which they live or work brings about the morals hence creating integrity. Personal values are rooted within the moral framework that a person was led to believe thus relating to it in case of decision making. During resolution of a challenge, one is most likely to relate the degree of severity within the problem to personal integrity (Frankel & PGCMS, 2018). On a normal scale, issues with low scale severity are forgotten while serious issues tend to create crises that come with higher levels of moral distress. This in turn affects the outcomes of an individual in all the domains including organizational (Grossman & Valiga, 2018). Value conflicts are the major causes of moral distress which could be countered by moral courage that allows an individual to speak up or reduce moral distress experienced by the people around. A leader therefore, needs to understand the moral cores and values embedded in integrity to help subordinates perform better and lead a moral distress free life at the work place.
According to the ANA Code of Ethics, the integrity of nurses in threatened daily in any health care environment. Nurse leaders are at a higher risk of violating their personal codes due to organizational pressure that demands performance and achievement of certain goals and objectives. In such a situation, the likelihood of moral distress is high and it will affect other nurses under the leadership of the distressed leader. All nurse leaders, regardless of their specialty, must support staff in working with all the relevant people around the hospitals in an effort to improve wellbeing and health. It includes service users, care givers, and patients. A nurse leader therefore, needs to be proactive and make rush decisions on behalf of the management and other nurses after accessing the situation (Grossman & Valiga, 2016). In case of a problem, it is the responsibility of the nurse leader to solve it instead of waiting for the busy managers and physicians who have loads of work. Taking initiative is a sign of responsibility hence good leadership. In case of a complaint from a patient about an uncomfortable bed, it is the role of the nurse to investigate and make sure of the patients comfort (Grossman &Valiga, 2016). Morals are also tested in this case since the nurse would put herself in the patient’s situation and realize that she is already uncomfortable from the sickness and comfort is the least she can offer.
A strong leader also needs to learn the art of delegating duties. Contrary to most opinions, taking care of everything without help is not a sign of strong leadership. Instead, it leads to accumulated pressure hence an increase in moral distress which in turn is transferred to subordinates and other staff members not to mention patients. The nurse leaders need to surround themselves with nurses who are good at specific duties such that in case of urgent need of a task, one is sure to get the best service from a specialist (Grossman & Valiga 2016). To fulfill such responsibilities, professional nurses offer support to other nurses who might be caught up in a dilemma and help them in sorting situations mostly through dialogue. For this to happen, the nurse managers need to create a suitable environment which should be inclusive of normal rounds.
The achievement of ethical reasoning is based on four principles which include autonomy, no maleficence, beneficence, and justice. Autonomy is defined by personal freedom of action which is an ethical principle that professional nurses should apply towards the care of patients. The nurse id given freedom to deliberate on nursing issues and actions and is given the capacity to make decisions based on their judgment of the situation (Frankel & PGCMS, 2018). The nurse also becomes an advocate for hospitalized patients since they might not be in a position to make autonomous decisions. Even so, the patient still has the right to make their decisions, but the nurse should help guide his family towards the best decision. It is also the role of professional nurses to avoid and look out for intentional harm or inflicting harm on others. This is the second principle which is nonmaleficence.
Nurses should learn to use restraints such that in case of risk, the patient comes first and must be protected. Some of the medicines and items like wrist restraints and tranquilizers could create potential for abuse. It is therefore, the responsibility of professional nurses to ensure safety of the patient and in case of errors, nurses are obliged to acknowledge and disclose to the physicians, patient, or the surrogate (Grossman & Valiga, 2018). Apart from that, they should also protect patients’ rights and also against incompetent practitioners. Beneficence is the art or ability to give people their freedom of choice, avoiding harm, and providing the best possible medical health and welfare. It goes hand in hand with justice which involves giving people what they rightfully or legally deserve in the spirit of being helpful.
Professional nurses need to possess knowledge on the legal framework and outcomes of their actions. They should always offer to help in different health related matters such as helping clinical nurses to balance their teaching, investigations, research, and patient care (Frankel & PGCMS, 2018). All this should come down to one objective which is social justice in an effort to promote quality care services as much as improve life. Nurses can also protest public policies that tend to reduce the quality of health services for the poor. This shows promotion of compassion and sensitivity which are core values that a nurse should possess. In the pursuit for human values in wholeness, nurses should not settle for lower salaries, instead, they should advocate for the cost to be shared equally by the community which also includes the government.
In critical unit cares, ethical issues seem to be higher compared than the rest of the hospital. Institutional ethics committees are therefore, advised in this case and the managing nurse should take course by creating nursing rounds aimed at sensitizing nurses on ethical values. With this, the nurses will be at a better position to avoid instances where they tend to prolong life as a heroic measure since they feel they are obliged to take care and protect the patient (Frankel & PGCMS, 2018). Actions of mercy as much as they might seem to be in line with the discussed core values of integrity might turn out to be unethical. Matters such as allocating resources inappropriately because one feels like a particular patient might need it more than the others should be condemned by leaders.
On a daily basis, professional nurses are faced with decision making dilemmas that could lead to loss of life. Leadership is therefore, essential to help in guidance to help them make choices as much as they should be allowed freedom to decide (Frankel & PGCMS, 2018). Nurses are the backbone of any health institution hence the need to invest in a good and achievable set of policies and ethics that guide and bring them back on the rightful path in case of straying which is part of human nature. Leaders should come up with different ways to reinforce integrity and ethics in health care to avoid loss of life or poor health care services.
Integrity and ethics are inborn in an individual, but can be polished and reinforced, but not forced on nurses. They should be allowed to practice their beliefs and thoughts to create a better working environment. As much as it is the work of nurses to protect the patient, nurses also need protection from unethical issues such as sexual abuse by seniors. The senior or managing nurses should be at a better position to ensure the safety of other nurses thus a friendly and appropriate working environment. Like Florence Nightingale envisioned, nursing is not only an art or a science, it is a natural blend of caring, being human and a large field of knowledge and exquisite skill.
Grossman, S., & Valiga, T. M. (2016). The new leadership challenge: Creating the future of nursing. FA Davis.
Frankel, A., & PGCMS, R. (2018). What leadership styles should senior nurses develop?. Practice, 10, 18.